Term
MRSA: prisoners, children in daycare, athletes
Legionella: smoking, males, recent hotel stay/cruise, DM, cancer, HIV
resistant S. pneumoniae: elderly, beta lactam in the past 3 months, alcoholism, immunosuppression, comorbidities, exposure to child in daycare |
|
Definition
| pathogen specific risk factors for pneumonia: MRSA, Legionella, Resistant S. pneumoniae |
|
|
Term
sample should be taken before the patient begins antibiotics
good cultures should have > 25 PMNs and < 10 squamous epithelial cells |
|
Definition
| what constitutes a good sputum sample? |
|
|
Term
Mycoplasma pneumoniae
S. pneumoniae
Haemophilus influenzae
Chlaymdia pneumoniae
Legionella pneumophila
viruses |
|
Definition
| what organisms are most likely to result in CAP? |
|
|
Term
S. pneumoniae
K. pneumoniae
oral anaerobes (increased risk of aspiration)
Acinetobacter species
Mycobacterium tuberculosis
KAMOS |
|
Definition
| which organisms should be considered in patients with alcoholism? |
|
|
Term
Haemophilus influenzae
Pseudomonas aeruginosa
S. pneumoniae
Legionella species
Moraxella catarrhalis
Chlamydophila pneumoniae |
|
Definition
| which organisms should be considered in patients with COPD/smoking |
|
|
Term
gram negative enteric pathogens
oral anaerobes |
|
Definition
| which organisms should be considered in patients at an increased apsiration risk? |
|
|
Term
S. aureus
M. tuberculosis
S. pneumoniae
anaerobes
SAMS |
|
Definition
| which organisms should be considered in IV drug users? |
|
|
Term
Macrolides (azithromycin, clarithromycin)
doxycycline
respiratory FQ
cephalosporins
ketolide
MDRCK |
|
Definition
| in general, which antimicrobials are recommended as empiric CAP therapy? |
|
|
Term
macrolide (azithromycin, clarithrymycin, erythromycin)
OR
doxycycline
OR
ketolide |
|
Definition
| what treatment for CAP is optimal for outpatient treatment in healthy adults? |
|
|
Term
respiratory FQ (moxi, levo)
OR
beta lactam (amoxicillin, augmentin) PLUS macrolide
OR
doxycycline PLUS a macrolide
OR
ketolide |
|
Definition
| which treatments are optimal for CAP in out patient adults with comorbidities? |
|
|
Term
| beta lactam (cefotaxime, ceftriaxone or ampicillin/sulbactam) PLUS a macrolide |
|
Definition
| which treatments are optimal for CAP in inpatient non ICU patients previously on a FQ in the last week? |
|
|
Term
| beta lactam (cefotaxime, ceftriaxone, or ampicillin/sulbactam) PLUS either azithromycin or a FQ |
|
Definition
| which treatments are optimum for CAP in inpatient ICU patients? |
|
|
Term
antipneumococcal, antipseudomonal beta lactam (piperacillin/tazobactam, cefepime, imipenem, meropenem) PLUS cipro or levofloxacin
OR
beta lactam PLUS aminoglycoside PLUS azithromycin
OR
beta lactam PLUS aminoglycoside PLUS antipenumnococcal FQ (levo or moxi) |
|
Definition
| which treatments for CAP are optimum if psuedomonas is suspected in a patient? |
|
|
Term
|
Definition
| which treatments for CAP are optimum if CA MRSA is suspected? |
|
|
Term
minimum of 5 days
typically 10-14 days
should be afebrile for 48-72 hours
should have no more than one CAP associated sign of clinical instability before discontinuing therapy
10-14 days for immunosuppressed or Legionella infection |
|
Definition
| how long should a patient be treated for CAP? |
|
|
Term
vaccination recommended
revaccination if patient received vaccine >/= 5 years previously and was aged < 65 at the time of vaccination |
|
Definition
| what are the influenza vaccination/revaccination recommendations for persons aged >/= 65 yo? |
|
|
Term
vaccination recommended
revaccination not recommended |
|
Definition
| what are the influenza vaccination/revaccination recommendations for persons aged 2-64 with chronic cardiovascular disease, chronic pulmonary disease, DM, alcoholism, chronic liver disease? |
|
|
Term
vaccination recommended
revaccination not recommended |
|
Definition
| what is the influenza vaccination/revaccination recommendations for persons aged 2-64 living in special environments or social settings (ex NH)? |
|
|
Term
vaccination recommended
revaccination:
if >/= 5 years have elaspsed since receipt of first dose
if patient aged < 10 yo consider revaccination 3 years after previous dose |
|
Definition
| what are the influenza vaccination/revaccination recommendations for immunocompromised persons: age >/= 2 yo and are immunocompromised including those with HIV, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, malignancy, chronic renal failure; those receiving immunosuppressive chemotherapy, and those who have received an organ or bone marrow transplant? |
|
|
Term
|
Definition
small changes in hemagluttinin and/or neuraminidase molecules
responsible for seasonal epidemics |
|
|
Term
|
Definition
virus acquires a new hemagluttinin and/or neuraminidase via genetic reassortment rather than point mutations
H1N1 |
|
|
Term
oseltamivir:
activity against - influenza A and B
use: treatment and chemoprophylaxis
FDA approved for treatment in people 1 yo and older and chemoprophylaxis in people 1 yo and older
contraindications: none
Zanamivir:
activity against - influenza A and B
use: treatment and chemoprophylaxis
FDA approved for: treatment in people 7 yo and older and chemoprophylaxis in people 5 yo and older
contraindications: people with underlying respiratory disease (asthma, COPD, etc) |
|
Definition
| what pharmacologic therapies are available for influenza and how do they compare? |
|
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